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Based on claims reviewed by the recovery audit contractor (RAC), First Coast has identified top denials for services within the category of vein ablation (codes 36475 and 36478) relating to endovenous radiofrequency ablation and laser treat…
To promote consistency in the claim submission process, follow these instructions when billing HCPCS code C9899.
This article provides guidance to avoid inappropriately billing Qualified Medicare Beneficiaries (QMBs) for Medicare cost-sharing, including deductibles, coinsurance, and copayments.
Avoid negative impacts to your claims by providing the medical records for the laboratory, pathology and other codes claims submissions indicated in this article. First Coast requests specific documentation with submission of these codes. P…
Medicare applies a MPPR to the payment of select therapy services. The reduction applies to HCPCS codes contained on the list of “always therapy” services, regardless of the type of provider or supplier furnishing the services. Find out the…
Providers may be billing these services incorrectly. Please review this article and pay close attention to the billing loop and segment information detailed within. The NCT number has been added to the instructions.
The requirements for the submission of claims under reciprocal billing and fee-for-time compensation arrangements are the same for assigned and non-assigned claims. This article shows when these requirements apply.
Learn the correct pairing of value codes (VC) and payer codes (PC) to use when billing different types of Medicare secondary payer (MSP) claims.
Medicare pays for cardiac rehabilitation (CR), intensive cardiac rehabilitation (ICR), and pulmonary rehabilitation (PR) programs if specific criteria are met. This criterion includes coverage provisions for CR, ICR, and PR items and servic…
The Office of the Inspector General (OIG) and other federal agencies have emphasized the importance of voluntarily developed and implemented compliance plans. The OIG has supplied guidance as to the elements of a model compliance plan.